December 29, 2008
We had taken our girls to Water Aerobics at the YMCA (Stephanie G with her daughter) to get our exercise during the Christmas break. After exercising and spending some time in the hot tub, my Stephanie and I were together in the YMCA's family shower room (I like the privacy in there instead of the main locker room). This is when she said: “Mom, would you look at my toe?” It was quite red at the top of the nail bed and pus was oozing out from between the nail and the skin at the top of the nail. It is her right big toe that I’m talking about. I knew right away that this was beyond the capabilities of Dr. Mom, so as soon as we got home, I arranged for her to be seen at her doctor's office.
It was the nurse practitioner that saw her and prescribed Augmenten 875 mg with warm/hot water soaks with Epson salts. We started the prescription that day and soaked her foot daily as requested.
I checked her foot from time to time and thought things were getting better, so after the prescription ended, I didn’t think about it much…
January 18, 2009
Stephanie stated that her stockings were sticking to her toe…the pus had returned! So we soaked in Epson salts again. On Monday I called and made an appointment with Dr. Anderson for after school on Tuesday. We soaked again on Monday.
January 20, 2009
Saw Dr. Anderson and was prescribed another antibiotic, Keflex 500 mg and recommended that she see a podiatrist. I had Steve call the podiatrist in Monroe for an appointment.
January 21, 2009
Saw Dr. Brunsman for the first time and he agreed with the prescription she was currently taking, however, instead of soaking in Epson salts, he wanted her to use a cotton ball soaked with a special salt solution directly on her toe for 10-15 minutes twice a day and not to wipe off the solution, but to use a hair dryer to dry the toe, then bandage it and put on a clean sock. This we did.
January 28, 2009
We were supposed to see the podiatrist, but the appointment times were messed up…I was ticked!
January 30, 2009
The toe is still not better! He swabbed the toe for a culture and gave us yet another antibiotic prescription, this time Augmenten 250 mg.
February 4, 2009
Stephanie stayed home from school…one look at her very pale face told me that she was indeed sick, but no fever. I called and had her foot appointment moved up from 4pm to 1:30. She started vomiting just before leaving for this visit. I was not happy with this visit at all! The culture came back negative and all he could say was maybe getting an x-ray??? I made the decision that going back to this doctor was not an option and getting an x-ray was not happening either. After getting home I made some phone calls to some infection control doctors that the nurse on the Premera phone line listed for me. After talking with some of them, I decided to do a Mom thing and took her to Children’s hospital.
Children’s was a very positive experience! They treated the whole Stephanie, not just the toe. She was given something for nausea and they numbed the toe and cleaned it out the best they could. They tried to get a sample to for a culture, but there wasn’t enough. Which made me realize that the culture taken from Dr. Brunsman was probably not valid either. Anyway, we left the hospital with Stephanie’s 4th antibiotic prescription, this time Clindamycin at 300mg for 10 days, and a medication to stop the diarrhea that the antibiotic causes.
February 9, 2009
Follow-up with Dr. Coe. He said to continue the prescription and if the toe was not skin tone at the end of 10 days, to keep taking it for another round.
February 14. 2009
Prescription renewed.
February 16, 2009
Both Stephanie and I had dermatology appointments for facial reasons and while we were there, I had her look at Stephanie’s toe and she recommended that she stay on the RX, but to put clotrimazole 1% cream on the toe two times a day to work on a possible yeast infection.
After much searching, we found that this cream is also a cream for athlete’s foot.
March 11, 2009
Stephanie comes home from school and says her toe hurts. It is warm to my touch. Mind you, I had been watching her toe from time to time during the bandage changes, and nothing seems to change.
March 12, 2009
Saw Dr. Johnson (her real pediatrician…finally!). A new prescription, sulfamethoxazole/tmp ds two times a day. Also, stop the cream and just use an antibiotic ointment, such as Neosporin. He also tried to take a sample for culture. Strongly recommended that she see Dr. Rod Moore, who has his office in the same building. Made the appointment for March 19th but if she gets a cancellation will let me know. Per Dr. Johnson, the toe is probably not now suffering from an infection, but tissue growth of some type. I also noted to him that in all my personal observation, there has been no nail growth at all since this started.
March 13, 2009
Took pictures.
March 14, 2009
Took more pictures, this time the nail has turned yellow and there is a dark patch under the nail (dead blood)…I am not happy!
March 15, 2009
Left message with Dr Moore’s office on answering machine, would like Stephanie to be seen on Tuesday instead of Thursday if at all possible…we shall see.
March 16, 2009
Dr. Moore’s office called and they will try to find a time to see Stephanie tomorrow. Then at 2pm I get a call from Dr. Johnson telling me that he got the culture back and that it was a bacteria infection of a type that lives in tennis shoes. Great! Which also means that the antibiotic she is taking is useless and to discontinue it. He also said that he would get the culture results up to Dr. Moore right away.
At 3:00 I’m tired of waiting for Dr. Moore’s office to call me back, so I called them, explained that I had been out doing errands and such (and laundry), do they have a time yet to see Stephanie. Yes…tomorrow morning at 8:45. We will be there!
March 17, 2009
Dr. Moore took one look at Stephanie’s toe and right off could tell that the nail needed to be removed…it was the cause of the problem. All we were doing were getting into a cycle of infection, clear up, infection, clear up…without taking care of the cause. He also took an x-ray of her foot just to make sure that the bones were not involved…and he made a remark that based on her foot plates that Stephanie was almost finished growing. Anyway, the hardest part of this for Stephanie was getting the shots that numb the toe so that he could remove the nail. That part of the procedure took so little time that even Stephanie was surprised when he was done. Only the top part of the nail was actually still attached to her toe, so its removal was pretty easy.
What is irritating to me is that I have tried on several visits to these doctors to tell them that the nail wasn’t growing out and was the cause of the infection…but no…Mom can’t be right…there has to be something else causing it. I’m sooooooooo glad that Dr. Moore was there and I feel much better now as Dr. Mom.
After getting Stephanie back to school, I personally went in and talked to the nurses and they wrote up a note for Stephanie to show to each teacher that she is allowed to leave the class two minutes early in order to avoid the rush of stomping feet and get to her next class on time.
Just before Stephanie got home from school, Dr. Moore’s nurse called and said that they were finally able to review the culture result that Dr. Johnson sent up to them and wanted Stephanie to go on yet another antibiotic. This time it is Cipro 500mg. You don’t get a much stronger antibiotic than this. We also have a follow-up appointment on the 27th. I sure hope that her toe looks pink again by then! As for the nail…it will grow back, it might take half a year, but it will come back.
Did you count them? Six different prescriptions of antibiotics for this toe! I sure hope this is the last one!
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